Medicine and Health Sciences Commons^™

Sexual Behavior And Substance Use Among Women Across The Spectrum Of Sexual Orientation, Margaret M. Wolff

Dissertations and Theses

Background: Compared to non-sexual minority women, sexual minority women are at greater risk for substance use and abuse, sexual risk behaviors, and unplanned teen pregnancy; few studies measure differing associations by sexual orientation (e.g., identity, behavior, attraction) or discordance (e.g., heterosexually-identified women with female partners) components. Minority stress may explain sexual minority women’s health disparities; thus, as U.S. policies evolve to reflect growing acceptance of all sexual minorities, research should examine sexual minority women’s health risk behaviors using multidimensional constructs of sexual orientation.

Methods: Using the female sample of the 2002-2013 National Survey of Family Growth (Aims 1-2 n=25,523; …

Drink Me And Abort Your Baby: The Herbal Abortion Tea, Maya Lewis

Capstones

For most of history every abortion was a herbal abortion. Herbal abortion is exactly what it sounds like––a series of herbs that, if taken at the right time, in the right form and dosage, can induce a miscarriage. It's risky, under researched and rarely supported. But with women's clinic dwindling all over the country and a president elect who wants to repeal Roe v. Wade, herbal abortion might soon make a major come back–– for better or worse.

Link to capstone project: https://medium.com/@maya.lewis/drink-me-and-abort-your-baby-the-herbal-abortion-tea-46aadd15f659

A Green Oasis: What Makes Community Gardens Worth Saving? While Researchers Amass Evidence Of Benefits, Advocates Develop New Strategy To Prove Their Value., Joel Wolfram

Capstones

Green Valley Community Garden in Brownsville, Brooklyn, is one of about a dozen gardens on land owned by the New York City Department of Housing Preservation and Development that are being uprooted by plans to build affordable housing. The gardeners are fighting back to prevent the garden’s destruction, saying that the food-producing green space is a source of healthy eating in a community with high rates of health problems, like diabetes and obesity. Researchers are attempting to tease out the public health benefits of community gardens as one metric of their value, but the science is still catching up with …

Preying On The Desperate, Karen M. Savage

Capstones

In this story, I investigate the marketing and sale of concentrated hydrogen peroxide to individuals who are desperate to cure serious health maladies. The story follows an online marketer who was warned by the FDA more than ten years ago to stop claiming hydrogen peroxide ingestion could cure cancer and other ailments. But in spite of the warning and subsequent FDA investigation, the individual continues to claim high strength hydrogen peroxide helps with brain tumors and leukemia and he can now be tied to several different websites marketing various “brands” of high strength hydrogen peroxide. Another marketer distributes hydrogen peroxide …

Cause For Question: Risk And Postmodern Panic In The Vaccine Safety Debate, Marygrace Trifilio

Theses and Dissertations

This thesis analyzes the thoughts and feelings of non-vaccinating parents in America and argues that contemporary vaccine refusal results from overwhelming information saturation in the Internet age. Non-vaccinating parents express distrust of competing scientific research and call for a return to a more natural, toxin-free lifestyle.

Community Schools: A Public Health Opportunity, Catherine Diamond

Dissertations and Theses

Community schools link students, families, and communities to educate children and strengthen neighborhoods. They have become a popular model for education in many U.S. cities in part because they build on community assets and address multiple determinants of educational disadvantage. Since community schools seek to have an impact on populations, not just the students enrolled, they provide an opportunity to improve community health. It has been proposed that community schools influence the health and education of the area residents through three pathways: building trust, establishing norms, and linking people to networks and services. However, no research has been published exploring …

An Evaluation Of The Effect Of Abortion Laws On The Timing Of Abortion, Elizabeth Fuentes

Dissertations and Theses

A record number of restrictive abortion laws, particularly those known as Targeted Regulation of Abortion Providers (TRAP), have been passed in US states in the past half-decade. TRAP laws differ from abortion laws that target patients, such as parental involvement and waiting period policies, because they are often expensive, difficult, or impossible for providers to comply with, resulting in the reduction or elimination of abortion services. This can result in farther travel to and higher costs of abortion services for patients; however, there are no studies assessing whether one consequence of reduced geographic accessibility of abortion services is delays in …

Patient And Family Engagement In Addressing Hospital Patient Safety Concerns: Experiences, Attitudes And Patient Safety Engagement Comfort Levels Of Recently Hospitalized Patients, Catherine M. Besthoff

Dissertations and Theses

Introduction

Patient engagement involves the behaviors of patients, family members, and health professionals (i.e., doctors, nurses, and other healthcare staff) in a collaborative partnership to improve health and healthcare. It also constitutes organizational structures policies and procedures designed to foster and promote the active inclusion of patients and family members in health services delivery. Patient engagement is associated with enriched patient experience, patient safety and clinical effectiveness. An evidence base is essential for its translation from a conceptual framework to tangible programs that can be pragmatically implemented in healthcare delivery systems. However, little is known about how individual level factors, …

Providing Care For Many In The Context Of Few Resources: Secondary Traumatic Stress, Burnout And Moral Distress Experienced By Healthcare Providers In Rural Uganda, Lauren Michelle Dewey

Dissertations, Theses, and Capstone Projects

In the context of the global nursing shortage, and particularly in low-resource settings, nurses are at an increased risk for work-related stress problems like secondary traumatic stress (STS), burnout, and moral distress. These three work-related mental health consequences, sometimes associated with absenteeism and intent to leave the profession, could potentially contribute further to the shortage of nurses. This two-part study is a longitudinal examination of the work-related mental health consequences experienced by healthcare providers in rural Uganda. In Study 1, participants (n=208; 159 students and 49 experienced health workers) completed self-report, psychosocial measures at baseline and 134 of the students …

The Effects Of Health-Related Fitness On School Attendance In New York City 6th-8th Grade Youth, Emily M. D'Agostino

Dissertations, Theses, and Capstone Projects

Background: Only 42% of youth ages 6-11 in the United States meet the World Health Organization’s recommendation for ≥60 minutes of daily moderate to vigorous physical activity. Estimates for adolescents ages 12-19 are even lower, ranging from 8-17%. Literature suggests low levels of youth health-related fitness (fitness) may negatively impact attendance, potentially due to reduced physical and psychosocial wellness. Nationally, 10-15% of (5-7.5 million) students are chronically absent, meaning that they miss ≥10% of the school year (or ≥20 days of school per year). Moreover, 20-30% of students in high-poverty, urban school districts do not attend school regularly (≥6 days …

Perceptions Of Fidelity And Adaptation In Evidence-Informed Interventions By Women Of Color Sexuality Health Educators, Sara C. Flowers

Dissertations, Theses, and Capstone Projects

Sexuality health educators (SHEs) adapt interventions to the participants’ needs in the dissemination and implementation of comprehensive sexuality education (CSE) programming. However, there is a lack of understanding of how, why and when SHEs make such adaptations. Success or failure of the transfer of prevention technology to practitioners occurs by determining community capacities and preparedness to adopt/adapt high-impact interventions to effectively manage implementation. Experts argue for evidence-informed interventions (EII), as opposed to evidence-based interventions (EBI), as the best way to incorporate research in applied settings. EBIs are solely guided by recommendations from current evidence, whereas EIIs recognize and incorporate the …

The Effects Of Job Characteristics On Home Care Workers’ Well-Being And Job Performance: Understanding The Psychosocial Effects Of Relational Care, Emily C. Franzosa

Dissertations, Theses, and Capstone Projects

Home care workers are the lowest-paid and most precarious segment of the health care industry. Although these workers provide critical, non-medical support that allows elderly and disabled individuals to remain in their homes, the workforce is highly unstable, due to low wages, a lack of supportive benefits like health coverage, paid leave and retirement support, poor working conditions and a physically and emotionally demanding workload. But a lack of consensus around the nature and value of home care has made “quality”, in terms of both jobs and care provision, difficult to define, measure or improve. While home care is a …

Development Of A Patient-Centered Health Literacy Toolkit For Audiology And Hearing Loss (The 'Hh Lit Kit'), Jennifer L. Gilligan

Dissertations, Theses, and Capstone Projects

The Patient-Centered Health Literacy Toolkit for Audiology & Hearing Loss (‘HH Lit Kit’) represents four years of inquiry into health literacy and Patient-Centered Care (PCC) in audiology. While awareness of health literacy continues to gain momentum in medicine and public health, there is a paucity of information on PCC and health literacy in audiology.

Low health literacy is linked to poorer health and poorer quality of life. Patients with hearing loss are at high risk for low health literacy. This presents a major concern because hearing loss affects the way information is processed, retained, and applied. Gaps have been identified …

Ethnicity Matters: Implications For Understanding And Acting Upon Disparities In Health Affecting Black Men In The United States, Helen V. S. Cole

Dissertations, Theses, and Capstone Projects

Compared to non-Hispanic whites, non-Hispanic blacks have higher rates of mortality from heart disease, cancer, cardiovascular disease, and HIV/AIDS. Black men have a life expectancy approximately 4.7 years than the life expectancy of non-Hispanic white men, due in part to higher prevalence of chronic disease among black men. Many factors are hypothesized to contribute to disparities in health between races, including differences in socioeconomic status; culturally-linked behaviors such as diet, substance use, and physical activity; access to quality healthcare and other resources; and experiences of racism, both institutional and interpersonal. However, in public health research, race is usually treated as …

Tobacco Cessation And The Household Budget: A Longitudinal Analysis Of Consumption And Heterogeneity In The United States, Erin R. Rogers

Dissertations, Theses, and Capstone Projects

Objectives:

This dissertation was designed to: (1) estimate the relationships between recent, long-term, and relapsed tobacco cessation and dollars spent on non-tobacco goods among households in the U.S., (2) estimate the relationships between recent, long-term, and relapsed tobacco cessation and the budget shares allocated to non-tobacco goods among households in the U.S., and (3) to identify and characterize unobserved heterogeneity in the relationship between tobacco cessation and dollars spent on alcohol and food.

Methods:

Using 2006-2012 Consumer Expenditure Survey (CES) data, a cohort of 6,739 tobacco-consuming households was created and followed for four quarters. Households were categorized during the fourth …

Sociodemographic And Geospatial Correlates Of Stillbirths And Neonatal Mortality In Indonesia (1993–2007), Alka Dev

Dissertations, Theses, and Capstone Projects

Little research has focused on the determinants of stillbirth and neonatal mortality in Indonesia despite the fact that the country has one of the highest rates of stillbirths in the world and one of the highest rates of neonatal mortality in Asia. Several areas have not been explored due to data limitations, such as shared risk factors and measurement challenges, which can inform health policy and interventions and guide future research. This dissertation addresses this gap by comparing measurement challenges for stillbirth and neonatal mortality and identifying risk factors for both using Indonesian reproductive health survey data. Differences in estimates …

Variation In Restaurant Sanitary Scores In New York City, Kyle Gregory

Theses and Dissertations

The purpose of this study was to determine whether restaurants that are homogenous in nature would exhibit substantially different hygiene scores based on the underlying consumer learning behaviors present in the neighborhoods in which the restaurants are located.

The Impact Of Foster Care On Depression: An Examination Of Placement Type And Mental Health Service Utilization Among Children And Adolescents, Kisha Cummings

Dissertations, Theses, and Capstone Projects

Background: Children and adolescents in foster care with a history of complex trauma such as neglect, emotional, physical, and sexual abuse have a greater odds of being clinically diagnosed with depression in adulthood compared to children and adolescents without such a history. The current study examines the prevalence of depression in a national sample of children and adolescents aged 7 to 17 years. This study asks whether a) foster care is associated with a greater prevalence of depression among children and adolescents in foster care compared to children and adolescents not in foster care; b) there is an association between …

Healthy Beginnings: Exploring The Impact Of Parental Stress And Relationship Quality On Birth Outcomes, Anna A. Divney

Dissertations, Theses, and Capstone Projects

This dissertation consists of three studies exploring the effects of maternal and paternal experiences of stress and perceptions of relationship quality on length of gestation and birth weight. The first study assessed the association of parental relationship quality with the baby’s length of gestation and birth weight among 2,072 families in the Fragile Families and Child Wellbeing study. Romantic relationships can be a substantial source of social support as well as stress, and have been shown to influence many health outcomes. Beyond crude relationship characteristics, however, few studies have assessed the association of other dimensions of relationship quality, such as …

The Impact Of Climate Variability And Conflict On Childhood Diarrhea And Malnutrition In West Africa, Gillian Dunn

Dissertations, Theses, and Capstone Projects

Objectives: This dissertation aims to contribute to our understanding of how climate variability and armed conflict impacts diarrheal disease and malnutrition among young children in West Africa. Two studies examine the associations between climate and diarrheal disease across the whole study area – ten countries in West Africa during the period 2008-2013. The third study examines diarrheal disease and malnutrition in Northeast Nigeria before (2008) and after (2013) the start of the current armed conflict in the area.

Methods: Outcome variables and child, caregiver, and household characteristics for these studies are from the Demographic and Health Surveys. Additional datasets include …

Multilevel Analysis Of Individual, Neighborhood, And Health Care Facility Characteristics Associated With Achievement And Maintenance Of Hiv Viral Suppression Among Persons Newly Diagnosed With Hiv In New York City, Ellen W. Wiewel

Dissertations, Theses, and Capstone Projects

Objective

To investigate the effect of individual, health care facility, and neighborhood characteristics on achievement and maintenance of HIV viral suppression, among New York City residents aged 13 years and older diagnosed with HIV between 2006 and 2012.

Methods

I used individual-level data from the New York City HIV surveillance registry and Case Surveillance-Based Sampling, facility-level data from the surveillance registry, and neighborhood-level data from the U.S. Census and American Community Survey. The outcomes of interest were first viral suppression after diagnosis (Aims 1 and 3; ≤400 copies/mL) and virologic failure after first suppression among persons who achieved suppression (Aim …

Re-Framing Informal Family Caregiving, Magdalena T. Ornstein-Sloan

Dissertations, Theses, and Capstone Projects

Informal family caregivers are the backbone of the long-term care system, providing an estimated 80% of the long-term care in the United States. Caregivers provide care to people with disabilities, the ill and older adults, often with little to no outside assistance from the formal long-term care system. Although caregivers receive attention in the academic literature, mainstream media and within public policy and services development, caregiver services continue to remain underutilized. The focus on service provision has various goals, including the desire to lessen the burden caregivers experience by providing services so they can provide care at home longer than …